London Drug Treatment Court

							First Year Update and Plans for Year Two
             A Community Collaboration
                              April 2011
 Colloquium   held September 2009
 Willingness in London community
 Offers for partnership
 Several agencies began to meet
 Support and leadership from crowns and
  defense
 Availability and interest from Judge Rabley
 Following the energy of “yes” (Wheatley)
 Modelled after other successful courts
    Toronto Drug Treatment Court
 John  Howard        ADSTV
  Society             WOTCH
 St. Leonard’s       LIHC
  Society             OW
 LPS
                      CAMH
 Federal Crown
                      MSL– Streetscape
 Provincial Crown
                      N’Amerind
 Defense Counsel
                      UWO Research
 Probation            Community
 30 day Assessment Period
 Phases of Treatment
 Certificates for Completion of Phases
 Intensive Addiction Counselling and Case
  Management
    Group
    Individual
 EducationSessions
 Criminogenic Thinking
 Anger Management
 Mandatory Drug Testing
 Weekly  Court Attendance
 System of Graduated Incentives and
  Sanctions
 Incentives and Sanctions are immediate and
  equitable
 Unsupervised Housing at WOTCH House
 Volunteerism
 Time Management
 Bail Supervision
 30 day assessment bed at SLCS (intermittent)
 Housing
    WOTCH House
    SLCS – Gallagher House – 30 day assessment
 Addiction    Counselling and Education
    ADSTV
 Health   / Primary Care
    LIHC NP
 Volunteering    (40 hours)
    Food bank (initially)
    SLCS
 UDS
    Gamma Dynacare
 London   Police Services
    Curfew checks, bail conditions
 JHS
    Groups for family, criminogenic thinking, anger
     management
    Sanctionable hours
    Bail supervision
 CAMH
    Evaluation
 Tuesdays
     Pre Court
     Court
 Intakeand screening to determine eligibility
 Assessment using ADAT Tools
     Pre/Post Comparison of scores
 ArtTherapy
 Program Phases I-III (30 Day assessment)
 Graduation Criteria
 Based on honesty about drug use
 Rooted in harm reduction philosophy
 Pain Management: a concern
 Physical Health: very poor health
 Trauma: is significant
 Self Management: difficulty handling pain,
  stress, decision – making
 Safe housing – many homeless or
  inadequately housed with family
 Instincts are to panic and run
Probation notes:
 increased attendance, reporting habits and
  better organization
 Increased access to counselling > usual
 Previously unsuccessful and now attending
  appointments
 Curfew checks more successful
 Reduction in drug use and apparent
  compliance with programming
 Reduced recidivism
 LDTCprogram Development and
 Implementation
    Is the program delivered in the manner in which
     it was originally intended
    Court, Treatment, Working Group/Steering
     Committee
 LDTC   Participant Process
    Does the program accomplish what it was
     intended to accomplish?
 Data   Collection Period
    LDTC Program Development/Implementation –
     qualitative- Summer 2009-June 30, 2011
    LDTC Participants-quantitative/qualitative June
     2010-June 30, 2011
 Year   One Report
    September 30, 2011 – qualitative analysis,
     descriptive quantitative analysis
 Qualitative   Timeline Analysis
    Initial meetings, colloquium, formation of
     working group, implementation of the program
 Partnership   Formation
    Key court/treatment components (Judge, Crown,
     Duty Council, Probation, bail Supervision, UDS),
     supporting services (adjunct treatment, housing,
     volunteer placement)
 Processes,   Protocols, Practices
    Admission criteria, rewards/graduated sanctions,
     graduation/discharge criteria, treatment
     program/plan
 Baseline
    Intake socio-demographic/psychological
     characteristics, legal involvement, substance
     use, family/social support systems
 Process
    Participant retention (rates, length of time in
     program)
    Changes in socio-demographic/psychological
     characteristics. Interpersonal / family
     relationships
    Changes in substance use
   Changes in legal involvement
   Factors associated with court / treatment
    compliance
   Availability / accessibility of community
    services/resources
   Participant perceptions, opinions, beliefs and
    experiences of the program (qualitative)
   Male                         Physical health issues –
   Age range 19-44               liver disease, MSK
                                  impairments, poor
   Incarcerated for theft,       nutrition (9)
    break & enter,
    shoplifting                  Mental health issues –
                                  childhood trauma and
   Addictions to opiates,        abuse, insomnia,
    cannabinoids and or           depression, anxiety (9)
    crack cocaine
                                 Developmental issues –
   Homeless or marginally        learning disability,
    housed (8)                    ADHD (4)
   Unemployed (9)               Strained or
   Living in poverty (8)         dysfunctional
                                  relationships (9)
 Saved   the criminal      Analyzed   over 500
  justice system over        urine drug screens
  $600,000                  Assisted 2
 Facilitated housing        individuals to
  for all 9 participants     maintain sobriety
 Provided                  Overall reduction in
  approximately              substance abuse for
  150 individual             all participants
  addiction                 Facilitated return to
  counselling sessions       school (1)
 Facilitated 112           Personal
  group treatment            identification
  sessions                   acquired (4)
 14 participants admitted – 11 males, 3
  females (June 30/10 – present)
 2 participants expelled from program after
  incurring new charges
 1 Male and 1 Female dropped out before or
  just after the 30 day mark
 1 Female transferred to Therapeutic Court
 Currently  8 active participants
 2 participants attended withdrawal
  management services and have completed
  short term residential treatment
 8 clients appear to be the maximum caseload
  at this time for 1.0 FTE staff (usually
  caseloads are 35-50)
 Day planners work
 Clients have multiple barriers
 Advocacy is key to overcoming barriers
 Health care is significant in early months
 Criminal thinking must be addressed
 Communication between partners essential
 We are learning about each other’s worlds
     Legal learning about counselling and vice versa
 Ourclients are hurting, afraid, in pain
 Change happens very slowly (trust)
 Donations
 YMCA  passes
 Programs at WOTCH House
 Person with Lived Experience – Security
  Tenant at WOTCH House
 Community Service Opportunities
 Employment Opportunities
 Allpartners carrying on for another year
 Seeking funding
 Sharing evaluation results
 Collaboration with other programs nationally
 CADTC conference in Toronto in Nov 2011
 Steering Committee – 4 x a year
 Operations Committee – 1 x month
 Regular Communication
 Planning on shared professional development
 2 retreats to date – annual plans
 Consensus Models for Decision Making
 http://www.nadcp.org/learn/all-rise


 Canadian   / Ontario version needed

 Questions?
 Discussion?
 Thank   you!